The Public Health Impact of Radon Exposure: Sources, Prevalence, and

Mitigation Dustin May

June 6th, 2019

Outline

• NORM• Radiation Health Effects• Radon Prevalence and Impact• Radon Migration• Radon Testing and Mitigation• Highlighted Studies

Radiation Basics• Spontaneous decay of a

nucleus• Three main types of natural

radiation emitted– Alpha particles – Helium

nucleus, positively charged• Significant momentum, no

penetrating power – Beta particles – electron or

position• Mostly negatively charged in

NORM– Photons – gamma or x-rays

• No mass or charge, electromagnetic radiation

NORM

• Nearly all terrestrial radionuclides are from:– Thorium series– Uranium series– Potassium-40

• Series parent radionuclides are primordial– Essentially stable in the environment– Likely formed via the r-process in neutron stars

• Uranium series more relevant to human health– Physiochemical properties and half-lives lead to more

exposure

NORM• Uranium Series

• Abundant in rock and soil

• Mixture of long and short half-lives

• Leads to complex relationships

• Ra is especially soluble

• Ra-226 is usually most concerning in water

• Rn is a noble gas, low adsorption, non-reactive

NORM• Thorium Series

• Th is more abundant than U

• Ra especially soluble

• Ra-228 usually most concerning in water

• Half-lives are very different than U series

Properties of Radon• Noble gas• Decays via alpha emission• Three natural isotopes

– 222Rn (often referred to as “Radon”), Progeny of 226Ra in Uranium series

• t1/2 = 3.8 days– 220Rn (often referred to as

“Thoron”), Progeny of 224Ra in Thorium series

• t1/2 = 55.6 sec– 219Rn (often referred to as

“Actinon”), Progeny of 223Ra in the Actinium series

• t1/2 = 3.96 sec• Not a major contributor to

radon exposure

Radioactive Equilibrium

Transient Equilibrium, daughter t1/2 < parent t1/2Secular Equilibrium, daughter t1/2 <<< parent t1/2

Radiation Effects

• Stochastic Effects– Based on probability– Generally no threshold

for effect– Likelihood of effect

increases with exposure– Severity dose-

independent– Ex. Cancer

• Deterministic Effects– Threshold for effect

• Threshold varies person to person

– Severity of effect is dose dependent above threshold

– Ex. Acute radiation poisoning

• Hair loss, erythema, death

Radiation Health Impacts

Radiation Exposure Models

• Linear No-Threshold (LNT) Model– Extrapolates through origin– Based on high-level

exposure

• Hormesis– Beneficial effect a low

exposure– Evidence supporting this

with radiation is very weak http://nuclearsafety.gc.ca/images/readingroom/healthstudies/linear-non-threshold-fig1-eng.jpg

Radiation Carcinogenesis• Direct vs. Indirect Effects

– Alpha/Beta - Direct kinetic or charged particle damage to DNA

– Gamma - Generation of free radicals, OH, O2

-

• Damage can cause cancerous mutations– Mis-repair of damage– Alterations to oncogenes,

tumor-suppressor genes– Disruption of cell cycle

checkpoints, apoptotic pathways

• Ex. TP53, p53 http://bioinformatics.org/p53/gif/intro2.gif

Radiation Exposure

https://19january2017snapshot.epa.gov/sites/production/files/styles/large/public/2015-04/ncrp_160_sources_of_radiation_exposure_pie_chart.jpg

Routes of Exposure to NORM

• Exposure from drinking water– Mostly uranium, radium, and their decay products

• Ground-shine from the environment– External exposure to gamma rays from NORM

• Cosmic radiation from space and the upper atmosphere– External exposure to gamma and neutrons

• Exposure in Air– From radon and thoron and their decay products

Disease Burden from Radon

• BEIR VI (1999)– Radon related deaths in US

estimated based on uranium miner epidemiologicalstudies

– Two models used to estimate excess risk from radon

– 15,400 or 21,800 death per year attributed to Radon exposure the the US

• (3,000 to 33,000) 95% CI

Radon in Air Prevalence

https://www.epa.gov/radon/epa-map-radon-zones

Radon in Water Prevalence

https://portal.ct.gov/DPH/Environmental-Health/Radon/Radon-in-Water

Radon Action Levels

• Radon in Air– EPA set an action level of

4 pCi/L in air for indoor air

– Not a risk based limit, but a practical one

– 1:10,000 lifetime cancer risk limit is infeasible

– Outdoor air averages 0.4 pCi/L

• Radon in Drinking Water– EPA proposed two limits

• 4,000 pCi/L for states with radon air mitigation programs

• 300 pCi/L for states without radon air mitigation programs

• Based on 1:10,000 dilution factor in the average home

Radon Migration

• Radon moves via two main processes– Passive diffusion

• Migration from high [Rn] to low [Rn]

– Flow• Movement of gas from

high pressure to low pressure

• Primary movement of radon in environment

Radon in Buildings• Radon enters through

crack/gaps in foundation– Sump pits of particular

concern• Radon can also enter

dissolved in water– Most radon is liberated

into air, small amounts remain in water

– Concentrations are highly variable depending on geologic composition

http://www.lifetimeradon.com/Content/files/radonEntry.png

Stack Effect

• Warm air rises and exits structure

• Pressure is lowered in lower levels

• Negative pressure gradient created between foundation and surrounding soil

• Radon gas flows into structure

https://www.pestcontrol-knoxville.com/images/stack-effect-lg.jpg

Structures at Risk

• Homes with basements– Older homes with compromised foundations– Homes with porous foundations– Poorly sealed structures, exacerbates stack effect

• Forced air systems in basements– Lowers basement pressure, increased stack effect– Circulates basement air throughout the home

Radon Testing

• Short-term testing (Several Days)– Inexpensive kits can be

purchased and placed throughout the home

• Kits are mailed away and tested

– Real-time monitors are also used

• Give graphical results, show variability over time

• Must be operated by a technician

Radon Testing

• Long-term testing (months)– Longer term tests can

look at seasonal variability

– Help to evaluate and monitor efficacy of mitigation

– More accurate than short term tests

Radon Testing

• Radon in Water– Collection without

faucet aerator– Must be sealed with no

headspace– Testing done by liquid

scintillation

Radon Mitigation

• Cannot simply vent indoor air outside

• Radon mitigation lower pressure of surrounding soil– Provides a pathway for

radon escape– Reduces pressure

differential between soil and structure

• Passive vs Activehttps://www.familyhandyman.com/wp-content/uploads/2019/01/gas.jpg

Radon Mitigation

• Radon in water can be removed– Usually via carbon

filtration or aeration– Concentrations impacts

method• Aeration must be done

outside the home prior to water entry or must be vented

https://www.wpb-radon.com/waterPhotos/shallowTray.jpg

Important Studies

Uranium Miners and Cancer• Retrospective

cohort study of Colorado uranium miners

• SMR standardized to similar white males in the region

• One of a number of studies to show strong evidence for radon causing lung cancer

Uranium Miners and Cancer

Iowa Radon Lung Cancer Study• Case-control study• Reconstructed

dose– Included home,

work, other areas• Validated exposure

assessments with field measurements

• Kriged outdoor radon concentrations

Iowa Radon Lung Cancer Study

• Odds ratios approaching significance• p-trend statistically significant

The Story of Stanley Watras• 1984• Nuclear power plant

worker in PA• Set off radiation monitors

at his the plant– No obvious source of

contamination• Investigations found

radon concentrations of 2,700 pCi/L in his home

• Without testing, his family would never have known

https://www.dupageradon.com/wp-content/uploads/2017/01/du9.jpg

Can You Answer the Public’s Questions About Radon?

• Does your state have a radon control program?

• Do you know where to refer the public if they call with questions about radon?

• Do you know if your state has a radon problem?

• Does your state have problems with radon in water?

Thank you

Mission: The State Hygienic Laboratory at the University of Iowaprotects and improves quality of life by providing reliableenvironmental and public health information through thecollective knowledge and capabilities of our organization.

dustin-may@uiowa.edu